Provider Demographics
NPI:1467433417
Name:KERN, JOANNE E (NP)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:E
Last Name:KERN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:1027 BELLEVUE AVE SUITE 145
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117
Mailing Address - Country:US
Mailing Address - Phone:314-768-8486
Mailing Address - Fax:636-496-3939
Practice Address - Street 1:1027 BELLVUE AVE SUITE 145
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117
Practice Address - Country:US
Practice Address - Phone:314-768-8486
Practice Address - Fax:636-496-3939
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO075925363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP18853Medicare UPIN
ILK07157Medicare PIN